| NPI | 1952338469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: VA 0101046772) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0101046772) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2020-11-09 |