| NPI | 1306124912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q9077) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q9077) |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2022-11-21 |