| NPI | 1528015518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: SC 15702) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: SC 15702) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2010-07-20 |