| NPI | 1326131657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 228199) |
| Additional Taxonomies | 207LH0002X Anesthesiology Hospice and Palliative Medicine (Licence: NY 228199) |
| 207L00000X Anesthesiology (Licence: NY 228199) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2022-02-26 |