| NPI | 1104263003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R5032) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R5032) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2025-08-07 |