| NPI | 1982894598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 200855) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA MD.200855) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2011-08-12 |