| NPI | 1740716232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 12612802-1205) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: UT 12612802-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10059362) | |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2022-07-18 |