| NPI | 1356755094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 11085893-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0050303) |
| 207L00000X Anesthesiology (Licence: UT 11085893-1204) | |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2019-08-14 |