| NPI | 1972582260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 19208) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-0321) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: AR E-0321) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2019-03-13 |