| NPI | 1144517467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX q7634) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301106733) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q7634) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2020-03-09 |