| NPI | 1134151756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX M4341) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M4341) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX M4341) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2010-11-28 |