NPI | 1225235179 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX M3643) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX M3643) |
Enumeration Date | 2007-07-02 |
Last Update Date | 2022-07-21 |