| NPI | 1346276680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N2989) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N2989) |
| 207L00000X Anesthesiology (Licence: CA A89164) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A89164) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A89164) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N2989) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2018-07-27 |