NPI | 1467434134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-00474) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 2011-00474) |
Enumeration Date | 2005-11-17 |
Last Update Date | 2022-04-21 |