NPI | 1043259880 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA MD.14699R) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ MA78363) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2018-03-17 |