NPI | 1396800488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A121616) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188153) |
Enumeration Date | 2006-12-27 |
Last Update Date | 2019-05-07 |