NPI | 1922218627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 13456) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 018864) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2007-07-08 |