| NPI | 1912075755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME58908) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME58908) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2015-09-25 |