| NPI | 1285664185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 52-94765-1205) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 52-94765-1205) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2016-08-12 |