| NPI | 1902884679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME67353) |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine (Licence: FL ME67353) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: FL ME67353) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME67353) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME67353) | |
| 207LH0002X Anesthesiology Hospice and Palliative Medicine (Licence: FL ME67353) | |
| 207L00000X Anesthesiology (Licence: FL ME67353) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2023-03-07 |