| NPI | 1477556025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 185247) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 185247) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2007-10-26 |