| NPI | 1588694269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX L5112) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L5112) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-04-11 |