NPI | 1821212176 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: LA 03684R) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 03684R) |
2085N0700X Radiology, Neuroradiology (Licence: LA 03684R) | |
Enumeration Date | 2007-04-11 |
Last Update Date | 2018-06-13 |