NPI | 1588923817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 2015-00999) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NC 2015-00999) |
Enumeration Date | 2012-05-07 |
Last Update Date | 2022-06-10 |