| NPI | 1376064170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 318905) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 318905) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2024-04-02 |