NPI | 1366860991 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX s2329) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S2329) |
207L00000X Anesthesiology (Licence: TX S2329) | |
Enumeration Date | 2014-04-01 |
Last Update Date | 2021-07-05 |