| NPI | 1295298834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 23872) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 23872) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2026-03-23 |