| NPI | 1992883201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 027597) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 027597) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 027597) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2019-01-17 |