NPI | 1205989605 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 4301055514) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301055514) |
208D00000X General Practice (Licence: MI 4301055514) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301055514) | |
Enumeration Date | 2007-01-19 |
Last Update Date | 2022-11-29 |