| NPI | 1629335591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX S9858) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX 282512) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 282512) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S9858) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2022-09-23 |