| NPI | 1932213568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME96382) |
| Additional Taxonomies | 208VP0000X (Licence: AR E4915) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-11-06 |