| NPI | 1669584686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CT 034195) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: CT 034195) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: CT 034195) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-01-25 |