NPI | 1619073707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301075567) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301075567) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2025-02-25 |