| NPI | 1871859587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX 7303) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P7307) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX P7303) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2023-08-15 |