NPI | 1336150945 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: TX H9876) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX H9876) |
208VP0000X Pain Medicine, Pain Medicine (Licence: TX H9876) | |
Enumeration Date | 2006-08-10 |
Last Update Date | 2008-07-01 |