| NPI | 1770589731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX P4780) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 227337) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 227337) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 227337) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 227337) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 227337) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX P4780) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2019-01-03 |