| NPI | 1952386435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX L9653) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L9653) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2024-05-07 |