| NPI | 1073730594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NY 225611) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NY 225611) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2024-04-02 |