| NPI | 1376854075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R0843) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101251422) |
| 207L00000X Anesthesiology (Licence: TX R0843) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101251422) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R0843) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2020-04-01 |