| NPI | 1710216841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q0953) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q0953) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q0953) | |
| Enumeration Date | 2009-12-20 |
| Last Update Date | 2024-03-27 |