NPI | 1326033879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 33212) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 33212) |
Enumeration Date | 2005-09-12 |
Last Update Date | 2019-04-24 |