| NPI | 1942300769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 045566) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 045566) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-05-18 |