| NPI | 1013112184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD4424444) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD4424444) |
| 207L00000X Anesthesiology (Licence: OH 094866) | |
| 207L00000X Anesthesiology (Licence: MA L-228109) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 01075062A) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-05-14 |