NPI | 1912240391 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 11476978-1205) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 11476978-1205) |
Enumeration Date | 2013-04-03 |
Last Update Date | 2019-12-20 |