| NPI | 1881890432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 16340) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2006033711) |
| 208600000X Surgery (Licence: NV 16340) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 16340) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2018-11-08 |