| NPI | 1982721106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: UT 7752966-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 7752966-1205) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2019-11-13 |