| NPI | 1649373697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME66919) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME66919) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME66919) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2018-03-17 |