| NPI | 1033182431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX F8637) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX F8637) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2007-12-13 |