| NPI | 1457309965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: WI 45177) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: IN 01083699A) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-01-28 |