| NPI | 1982626818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: PA MD422681) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD422681) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2013-03-15 |