| NPI | 1144521436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 185419-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 185419-1) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 185419-1) | |
| 208000000X Pediatrics (Licence: NY 185419-1) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 185419-1) | |
| 2081H0002X (Licence: NY 185419-1) | |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2016-04-05 |