NPI | 1699069104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX q7519) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q7519) |
208VP0000X Pain Medicine, Pain Medicine (Licence: CO DR.74599) | |
Enumeration Date | 2011-06-01 |
Last Update Date | 2025-04-03 |