| NPI | 1336582881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CT 60327) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 287120) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NY 287120) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: CT 60327) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: NY 287120) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CT 60327) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 287120) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2023-08-07 |