| NPI | 1043741507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 70302-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 70302) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2026-06-02 |