| NPI | 1639120801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OR MD18619) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: OR MD18619) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OR 18619) | |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2021-06-29 |