| NPI | 1669762191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q3806) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q3806) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q3806) | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2023-02-23 |