| NPI | 1598726903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AR R-4114) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AR R4114) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: AR R4114) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2007-07-08 |