| NPI | 1861422479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX L8186) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L8186) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-08-22 |