| NPI | 1336137785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX L9393) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L9393) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2015-08-25 |