| NPI | 1013146216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 251646) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 251646) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NY 251646) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2016-02-12 |