| NPI | 1427583566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 75027) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: RI LP04360) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 309546-01) | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2025-02-06 |