| NPI | 1114973922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AR E4737) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R5039) |
| 207L00000X Anesthesiology (Licence: TX R5039) | |
| 207L00000X Anesthesiology (Licence: AR E4737) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-05-14 |