| NPI | 1073582458 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX L8668) | 
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX L8668) | 
| Enumeration Date | 2006-03-16 | 
| Last Update Date | 2022-12-12 |