| NPI | 1528059201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 5912590-1205) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 59125901205) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 24865) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2026-04-02 |