| NPI | 1497782932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01045317A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01045317A) |
| 111NX0800X Chiropractor, Orthopedic (Licence: IN 08001557A) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2015-04-30 |