NPI | 1760477103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 33862) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 33862) |
Enumeration Date | 2005-09-12 |
Last Update Date | 2024-01-23 |