| NPI | 1679884977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: DE C1-0013736) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 310833-01) |
| 207L00000X Anesthesiology (Licence: ME MD25629) | |
| 207L00000X Anesthesiology (Licence: VT 042-0014502) | |
| 207L00000X Anesthesiology (Licence: IL 125062215) | |
| 207L00000X Anesthesiology (Licence: PA MD457924) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA11040500) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C1-0013736) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2022-11-23 |