NPI | 1801821715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME92792) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME92729) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2018-12-11 |