NPI | 1093973984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: LA MD.04518R) |
Additional Taxonomies | 208800000X Urology (Licence: LA MD04518R) |
Enumeration Date | 2008-05-28 |
Last Update Date | 2020-06-03 |