| NPI | 1669588463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AL 26975) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 114982) |
| 207L00000X Anesthesiology (Licence: AK 4399) | |
| 207L00000X Anesthesiology (Licence: PA MD-070139-L) | |
| 207L00000X Anesthesiology (Licence: AR E-3049) | |
| 207L00000X Anesthesiology (Licence: MT 8798) | |
| 207L00000X Anesthesiology (Licence: WV 22130) | |
| 207L00000X Anesthesiology (Licence: KS 04-29071) | |
| 207L00000X Anesthesiology (Licence: IL 036-071941) | |
| 207L00000X Anesthesiology (Licence: GA 058573) | |
| 207L00000X Anesthesiology (Licence: FL ME103218) | |
| 207L00000X Anesthesiology (Licence: CA A44553) | |
| 207L00000X Anesthesiology (Licence: AL 00026975) | |
| 208D00000X General Practice (Licence: AL 26975) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-10-23 |