NPI | 1639109739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MS 16407) |
Additional Taxonomies | 174400000X Specialist (Licence: MS 16407) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2021-07-14 |