| NPI | 1942861638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX T0993) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T0993) |
| 207P00000X Emergency Medicine (Licence: TX T0993) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2025-08-14 |