NPI | 1457640708 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301098087) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301098087) |
207LA0401X Anesthesiology, Addiction Medicine (Licence: MI 4301098087) | |
208100000X Physical Medicine & Rehabilitation (Licence: MI 4301098087) | |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4301098087) | |
Enumeration Date | 2011-04-06 |
Last Update Date | 2025-04-18 |