| NPI | 1326466525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 270044) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 270044) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2025-09-28 |