| NPI | 1275825002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 88151) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S9466) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME124453) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME124453) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 202202501) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 88151) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME124453) | |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2023-12-28 |