| NPI | 1376864512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q2515) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q2515) |
| 174400000X Specialist (Licence: TX Q2515) | |
| 207L00000X Anesthesiology (Licence: TX Q2515) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2025-09-11 |