| NPI | 1467199588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2023048831) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2023048831) |
| 207P00000X Emergency Medicine (Licence: OK 8856) | |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2026-07-28 |