| NPI | 1336126036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX H3856) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX H3856) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX H3856) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX H3856) | |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2020-02-14 |