| NPI | 1184867418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q1998) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q1998) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2015-09-04 |