| NPI | 1528117199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 244996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 244996) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 244996) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 244996) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 244996) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2017-04-18 |