| NPI | 1881768596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 12072) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 12072) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2011-04-13 |