| NPI | 1518963339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: SD 3391) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SD 3391) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SD 3391) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2021-03-11 |