| NPI | 1215432901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME165604) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME165604) |
| 242T00000X Perfusionist | |
| 207R00000X Internal Medicine (Licence: TX 613883) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2026-01-05 |