| NPI | 1619162104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 44633) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 44633) |
| 207L00000X Anesthesiology (Licence: KY 44633) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 44633) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 44633) | |
| Enumeration Date | 2007-09-08 |
| Last Update Date | 2024-02-13 |