| NPI | 1467706168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX S9378) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S9378) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2024-11-15 |