| NPI | 1568187086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0000X Registered Nurse, Pain Management (Licence: MD R241093) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R241093) |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2022-10-06 |