| NPI | 1407912223 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 18456) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01059275A) | 
| 207L00000X Anesthesiology (Licence: GA 052181) | |
| 207L00000X Anesthesiology (Licence: OH 35082500M) | |
| 207L00000X Anesthesiology (Licence: CA A87740) | |
| 207L00000X Anesthesiology (Licence: VA 0101233699) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MS PC-00065) | |
| Enumeration Date | 2006-12-28 | 
| Last Update Date | 2017-03-03 |