| 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: OR MD208541) |
| 207Q00000X Family Medicine (Licence: OR MD208541) | |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2023-08-08 |