| NPI | 1003893397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX K1931) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K1931) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX K1931) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX K1931) | |
| 208VP0000X (Licence: TX K1931) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-06-29 |