| NPI | 1295718351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 220814) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 220814) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 220814) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2021-04-05 |