| NPI | 1952831216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD469046) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD469046) |
| 207P00000X Emergency Medicine (Licence: PA MT214377) | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-10-04 |