| NPI | 1417299538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R3912) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R3912) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2025-08-14 |