| NPI | 1376905570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX S0697) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S0697) |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2026-04-02 |