NPI | 1972575215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME78743) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME78743) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2023-03-07 |