NPI | 1518968916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 217744) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 217744) |
208VP0000X Pain Medicine, Pain Medicine (Licence: NY 217744) | |
Enumeration Date | 2005-08-09 |
Last Update Date | 2015-02-02 |