| NPI | 1598735334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 025949) |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA 025949) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: LA MD.025949) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2024-03-27 |