| NPI | 1679792527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 37595) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 37595) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2014-02-10 |