| NPI | 1316169170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MT MED-PHYS-LIC-164508) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N0831) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N0831) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2026-05-26 |