| NPI | 1528089588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 200400328) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 200400328) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2015-09-03 |