| NPI | 1366456162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 48818) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 48818) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: MD D69123) | |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: MD D69123) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 48818) | |
| 207L00000X Anesthesiology (Licence: MD D69123) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2022-06-08 |