NPI | 1306475470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: AR E-16590) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-16590) |
Enumeration Date | 2020-04-02 |
Last Update Date | 2023-11-15 |