NPI | 1710963681 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AK MEDS6318) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 4476) |
Enumeration Date | 2005-12-21 |
Last Update Date | 2020-03-31 |