| NPI | 1871889287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NE 29166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R72483) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2017-01-19 |