| NPI | 1841282290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX F1971) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F1971) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX F1971) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2018-12-06 |