| NPI | 1073976999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 294510-1) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 294510) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-10-02 |