| NPI | 1508000332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA l071618) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 071618) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 071618) | |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2014-10-22 |