NPI | 1972625853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KS 534506) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 062351) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OK 5654) | |
Enumeration Date | 2007-04-04 |
Last Update Date | 2015-04-07 |