| NPI | 1023134863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NM CNP01051) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA AP30007611) |
| 363L00000X Nurse Practitioner (Licence: NM R44461) | |
| 363L00000X Nurse Practitioner (Licence: NM CNP01051) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-07-10 |