NPI | 1811978075 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA MD60335313) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60335313) |
207L00000X Anesthesiology (Licence: WA MD60335313) | |
Enumeration Date | 2005-11-07 |
Last Update Date | 2017-03-02 |