| NPI | 1699760264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX L8263) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L8263) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: LA MD205930) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA MD205930) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2023-09-28 |