| NPI | 1528051869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 191595) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 191595) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 191595) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2010-10-28 |