| NPI | 1518929397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX K6317) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K6317) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2013-12-04 |