| NPI | 1861717704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA 20A11892) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A11892) |
| 208M00000X Hospitalist (Licence: CA 20A11892) | |
| Enumeration Date | 2010-04-04 |
| Last Update Date | 2018-12-27 |