| NPI | 1932130143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 015684) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 15684) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2017-02-07 |