| NPI | 1992712137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine Sports Medicine (Licence: TN MD45987) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TN MD45987) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2012-11-07 |