| NPI | 1245594985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 90833) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 28612) |
| 207L00000X Anesthesiology (Licence: MA 266119) | |
| 207L00000X Anesthesiology (Licence: OH 35.140606) | |
| 207L00000X Anesthesiology (Licence: GA 90833) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 90833) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 266119) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: WV 28612) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35.140606) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2024-01-09 |