| NPI | 1063492304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: UT 71112893-1204) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: UT 7112893-1204) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: UT 71112893-1204) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 71112893-1204) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2011-12-14 |