| NPI | 1790794063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 7596444-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 7596444-1205) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-08-07 |