NPI | 1801866215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 019030) |
Additional Taxonomies | 174400000X Specialist (Licence: LA 019030) |
Enumeration Date | 2006-01-26 |
Last Update Date | 2008-09-25 |