| NPI | 1225026230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K3753) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX K3753) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2023-02-28 |