| NPI | 1154374817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 207762) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY A207762) |
| 207L00000X Anesthesiology (Licence: NY 207762) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-05-19 |