| NPI | 1841345808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: AL DO459) |
| Additional Taxonomies | 170100000X Medical Genetics, Ph.D. Medical Genetics (Licence: AL DO459) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2012-10-12 |