| NPI | 1457507469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 247979-1) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 247979) |
| Enumeration Date | 2008-08-09 |
| Last Update Date | 2015-04-13 |