| NPI | 1649432329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 67179) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD444794) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: PA MD444794) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 16063) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IA 40894) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 67179) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-05-08 |