| NPI | 1396181350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R6132) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX r6132) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R6132) | |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2021-04-30 |