| NPI | 1912137910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N3887) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX N3887) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2023-12-05 |