| NPI | 1043573892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q9767) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125061134) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 57404) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q9767) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2021-07-27 |