| NPI | 1285776526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 43770) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 43770) |
| 207L00000X Anesthesiology (Licence: MO 2010105024) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2010105024) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 43770) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-12-09 |