| NPI | 1225031552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX K0794) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX K0794) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX K0794) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX K0794) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2007-08-16 |