| NPI | 1669670360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: KY 49929) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MS 20443) |
| 207L00000X Anesthesiology (Licence: MS 20443) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MS 20443) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2024-06-17 |