| NPI | 1538368923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: SC 32237) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 19223) |
| 207L00000X Anesthesiology (Licence: NC 2008-01579) | |
| 207L00000X Anesthesiology (Licence: SC 32237) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NC 2008-01579) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: SC 32237) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NC 2008-01579) | |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2024-05-23 |