| NPI | 1932146842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME95933) |
| Additional Taxonomies | 2084N0600X (Licence: GA 053530) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2022-05-26 |