| NPI | 1821035916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 21721) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: OK 21721) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-09-10 |