| NPI | 1588872691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 7906649-1205) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2010-00183) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2014-06-10 |