| NPI | 1063436947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX S9055) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 24887) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: OK 24887) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OK 24887) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-01-29 |