NPI | 1033620778 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 17-1668) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 17-1668) |
Enumeration Date | 2017-10-21 |
Last Update Date | 2017-10-21 |