NPI | 1568428589 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX G1674) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX G1674) |
Enumeration Date | 2006-04-26 |
Last Update Date | 2022-11-07 |