| NPI | 1447273560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 1000) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WV 1000) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |