| NPI | 1326091976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: PA MD444600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01061294A) |
| 207P00000X Emergency Medicine (Licence: PA MD444600) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-03-07 |