| NPI | 1336131739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 178131) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 178131) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2023-10-09 |