| NPI | 1760417745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R7898) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R7898) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D0068632) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-05-18 |