| NPI | 1700883014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 8421) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 8421) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NV 8421) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 8421) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2017-09-12 |