| NPI | 1699837260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD H65343) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0102201971) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA OS012662) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: DC DO034242) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-03-24 |