| NPI | 1669558136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX K7495) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K7495) |
| 207Q00000X Family Medicine (Licence: TX k7495) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2024-04-26 |