NPI | 1730684267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA MD61417375) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61417375) |
207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD61417375) | |
Enumeration Date | 2018-03-27 |
Last Update Date | 2024-09-18 |