NPI | 1457707333 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MA 287570) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 287570) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 287570) | |
Enumeration Date | 2016-05-10 |
Last Update Date | 2024-04-22 |