| NPI | 1023049418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: UT 180204-1205) |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine (Licence: UT 1802048905) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: UT 1802048905) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2014-03-21 |