| NPI | 1346500741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 275596) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 275596) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 275596) | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2023-02-20 |