| NPI | 1255564290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 42977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 42977) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: KY 42977) | |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2026-07-28 |