NPI | 1104037878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 7514078-1205) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R7512) |
207LP2900X Anesthesiology, Pain Medicine (Licence: TX BP10033560) | |
Enumeration Date | 2007-05-24 |
Last Update Date | 2015-02-04 |