NPI | 1407845563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX P1176) |
Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: LA 15291R) |
Enumeration Date | 2005-10-20 |
Last Update Date | 2024-08-08 |