| NPI | 1447287115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AL DO880) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AL DO.880) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-07-02 |