NPI | 1942399548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N2242) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX N2242) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N2242) | |
Enumeration Date | 2006-10-12 |
Last Update Date | 2022-07-21 |