| NPI | 1568410223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: SC 15488) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 15488) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-12-29 |