| NPI | 1558479261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: RI MD14068) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CT 51390) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2018-12-06 |