| NPI | 1972593457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: AL 25803) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AL 25803) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2012-11-05 |