| NPI | 1942475538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 2464812) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A103576) |
| 207L00000X Anesthesiology (Licence: NH 18710) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME137731) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A103576) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 15022) | |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2023-03-27 |