NPI | 1710245964 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 302153) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 302153) |
Enumeration Date | 2012-04-25 |
Last Update Date | 2018-03-29 |