| NPI | 1679567812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS7127) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS7127) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL OS7127) | |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: FL OS7127) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS7127) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS7127) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL OS7127) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2022-10-10 |