| NPI | 1992196026 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX S9175)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 1600)  | 
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S9175)  | |
| 207L00000X Anesthesiology (Licence: TX S9175)  | |
| Enumeration Date | 2015-02-11 | 
| Last Update Date | 2025-10-14 |