| NPI | 1891923546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 71789) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 22503) |
| 207L00000X Anesthesiology (Licence: SC 51553) | |
| 207L00000X Anesthesiology (Licence: MI 4301094817) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: LA MD.207659) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 51553) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 71789) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: SC 51553) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-09-08 |