NPI | 1972869345 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 17024) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 17024) |
207LP2900X Anesthesiology, Pain Medicine (Licence: NV 17024) | |
Enumeration Date | 2012-04-10 |
Last Update Date | 2022-07-21 |