| NPI | 1619924701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D0055800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D55800) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2015-08-06 |