| NPI | 1225371628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX R5960) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R5960) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R5960) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R5960) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2024-08-12 |