| NPI | 1164715686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 279538) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 279538) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2018-03-21 |