| NPI | 1467447003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2000169519) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2000169519) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2007-10-15 |