| NPI | 1508858804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OK 11470) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 11470) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2012-08-13 |