| NPI | 1730193665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 9700847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9700847) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-08-21 |