| NPI | 1770994550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 9529254-1205) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: UT 9529254-1205) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2021-10-29 |