| NPI | 1447146048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301508627) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: MI 4301508627) |
| 202D00000X Integrative Medicine (Licence: MI 4301508627) | |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2026-03-21 |