| NPI | 1891987160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 21695) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 201734) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2021-11-24 |