NPI | 1578594057 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 025102) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 025102) |
207Q00000X Family Medicine (Licence: GA 025102) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2023-03-29 |