| NPI | 1083604888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 240842) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX J4668) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: TX J4668) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 240842-1) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA BR3724514) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: PA BR3724514) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2016-11-29 |