NPI | 1548585417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: CA G136863) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D30413) |
Enumeration Date | 2010-04-02 |
Last Update Date | 2020-08-10 |