| NPI | 1457362386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD420090) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: DE C1-0007098) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2018-11-29 |