NPI | 1902433402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX V8843) |
Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NV 3206) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-25 |
Last Update Date | 2025-06-09 |