| NPI | 1730400193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2014-01082) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2010017377) |
| 207L00000X Anesthesiology (Licence: MA 264591) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 264591) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2914-01082) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2022-07-21 |