| NPI | 1255535811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX M6138) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M6138) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX M6138) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX M6138) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2018-02-16 |