| NPI | 1376842591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX Q6039) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX Q6039) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q6039) | |
| 207R00000X Internal Medicine (Licence: TX Q6039) | |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2024-12-06 |