| NPI | 1760438642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2007017247) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 15564) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: NV 15564) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 15564) | |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: MO 2007017247) | |
| 207L00000X Anesthesiology (Licence: NV 15564) | |
| 208VP0000X (Licence: NV 15564) | |
| 207L00000X Anesthesiology (Licence: MO 2007017247) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2026-05-08 |