| NPI | 1073558557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 227659-1) |
| Additional Taxonomies | 208VP0000X (Licence: NY 227659-1) |
| 207L00000X Anesthesiology (Licence: NY 227659) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2014-11-19 |