| NPI | 1366443640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: GA 028344) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 028344) |
| 207RS0012X Internal Medicine Sleep Medicine (Licence: GA 028344) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-07-24 |