| NPI | 1497798854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: GA 041733) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: GA 041733) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2022-10-28 |