| NPI | 1447233895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX R3560) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07567700) |
| 2083B0002X Preventive Medicine Obesity Medicine (Licence: TX R3560) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2025-04-30 |