| NPI | 1770710006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q0426) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 243517) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2017-07-13 |