NPI | 1396308078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MA 1020225) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1020225) |
Enumeration Date | 2019-04-17 |
Last Update Date | 2024-08-23 |