NPI | 1053555755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N3819) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX N3819) |
Enumeration Date | 2009-04-24 |
Last Update Date | 2013-12-10 |