| NPI | 1447363312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 291245) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 100207) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 291245) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-10-14 |