| NPI | 1396971826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q0924) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q0924) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2023-03-22 |