| NPI | 1881034346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 4285) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NE 1232) |
| 208VP0000X (Licence: TN 4285) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2025-12-30 |