| NPI | 1750543476 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX S3137) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD445800) | 
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD445800) | |
| 208VP0000X (Licence: TX S3137) | |
| Enumeration Date | 2008-06-25 | 
| Last Update Date | 2023-02-23 |