| NPI | 1013134196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX P0796) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TX P0796) |
| 207L00000X Anesthesiology (Licence: FL OS9987) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P0796) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX P0796) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: LA DO000109) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-12-01 |