| NPI | 1033353313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME115422) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.121076) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME115422) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.121076) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35.121076) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME115422) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 35.121076) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME115422) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2021-11-30 |