| NPI | 1144481128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MD D0088840) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MD D0088840) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D0088840) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2026-08-25 |