| NPI | 1649230491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 1316) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV 11664) |
| 207R00000X Internal Medicine (Licence: NV 224261) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2016-08-16 |