| NPI | 1457413668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 040613) |
| Additional Taxonomies | 208VP0000X (Licence: MA 040613) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 040613) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2008-09-22 |