| NPI | 1326314584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R3458) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R3458) |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2023-06-02 |