NPI | 1861465627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MO 2001016005) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2001016005) |
Enumeration Date | 2006-02-10 |
Last Update Date | 2014-12-17 |