| NPI | 1558322206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 181881) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 181881) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2021-08-16 |