NPI | 1992965982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX P3056) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P3056) |
207L00000X Anesthesiology (Licence: NC 2013-01741) | |
207LP2900X Anesthesiology, Pain Medicine (Licence: TX P3056) | |
208VP0000X Pain Medicine, Pain Medicine (Licence: NC 2013-01741) | |
Enumeration Date | 2008-06-12 |
Last Update Date | 2021-07-08 |