| NPI | 1548249931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2020040998) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 35336) |
| 207L00000X Anesthesiology (Licence: IL 036101708) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: IA 35336) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MO 2020040998) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IA 35336) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2022-07-25 |