| NPI | 1457569188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IA 38968) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: IA 38968) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2022-10-21 |