| NPI | 1073873386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q6729) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q6729) |
| 207L00000X Anesthesiology (Licence: TX Q6729) | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2018-03-17 |