| NPI | 1265963722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 8102740-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS17829) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 8102740-1204) | |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2024-04-23 |