NPI | 1699971465 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: LA MD206599) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD206599) |
Enumeration Date | 2007-06-26 |
Last Update Date | 2025-08-26 |