NPI | 1104007319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2009-01646) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2009-01646) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 32468) | |
Enumeration Date | 2007-11-15 |
Last Update Date | 2015-07-21 |