| NPI | 1689751620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MA 212790) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 047639) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: RI MD11073) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 212790) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CT 047639) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: RI MD11073) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-05-04 |