NPI | 1720125131 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 030873) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 030873) |
207LP2900X Anesthesiology, Pain Medicine (Licence: GA 030873) | |
Enumeration Date | 2007-02-01 |
Last Update Date | 2014-06-18 |