| NPI | 1538182647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NM 20040156) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX K8318) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NM 20040156) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R8318) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-07-21 |