| NPI | 1023542008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 317458-01) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 317458) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: NY 317458) | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2024-09-18 |