| NPI | 1497784268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 16058) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 22388) |
| 207L00000X Anesthesiology (Licence: KY 25360) | |
| 207L00000X Anesthesiology (Licence: OH 35079799M) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WV 16058) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35079799M) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 22388) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 25360) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WV 16058) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2025-03-07 |