| NPI | 1487101259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX S4891) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S4891) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2023-04-19 |