NPI | 1376740803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 19491) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 2200) |
Enumeration Date | 2007-06-28 |
Last Update Date | 2018-03-17 |