| NPI | 1851381818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: TX L7549) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: KY 51730) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: CA A91164) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX L7549) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2019-08-14 |