| NPI | 1508884057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD16898) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR 16898) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: OR MD16898) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-05-23 |