| NPI | 1346549219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301098964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301098964) |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: MI 4301098964) | |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: MI 4301098964) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301098964) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 4301098964) | |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2015-11-16 |