| NPI | 1821392986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R3542) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 276556-1) |
| 207L00000X Anesthesiology (Licence: PA MD455437) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 276556-1) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35132384) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 276556-1) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX R3542) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 276556-1) | |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2025-03-21 |