| NPI | 1982666830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 9401393) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 39930) |
| 208VP0000X (Licence: KY 39930) | |
| 207L00000X Anesthesiology (Licence: KY 39930) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 39930) | |
| 207L00000X Anesthesiology (Licence: NC 9401393) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2025-10-14 |