| NPI | 1225240641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D60913) |
| Additional Taxonomies | 207LH0002X Anesthesiology Hospice and Palliative Medicine (Licence: MD D60913) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MD D60913) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: MD D60913) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MD D60913) | |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2007-07-09 |