| NPI | 1942399548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N2242) |
| Additional Taxonomies | 208VP0000X (Licence: TX N2242) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N2242) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-07-21 |