| NPI | 1700867413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 228217-1) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX J0434) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD H0073176) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0102201908) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN DO0000002111) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB09495900) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-01-09 |