| NPI | 1942792981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 62713) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R76645) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2024-09-27 |