| NPI | 1568417871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MD D0056796) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D56796) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2015-08-06 |