| NPI | 1962651893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D72402) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME101473) |
| 207L00000X Anesthesiology (Licence: DC MD039848) | |
| 207L00000X Anesthesiology (Licence: VA 0101249477) | |
| 207L00000X Anesthesiology (Licence: MD D72402) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA md439841) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: DC MD039848) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101249477) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D72402) | |
| 207R00000X Internal Medicine (Licence: NY D72402) | |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2022-04-14 |