| NPI | 1407067929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2012-01447) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 098280) |
| 207L00000X Anesthesiology (Licence: LA MD.203861) | |
| 207L00000X Anesthesiology (Licence: NC 2012-01447) | |
| 207L00000X Anesthesiology (Licence: SC 34704) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 098280) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 34704) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 098280) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2012-01447) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 34704) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2025-06-10 |