| NPI | 1477557437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX L4708) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY A205878-1) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX L4708) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY A205878-1) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD428582) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD428582) | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2021-03-02 |