| NPI | 1568660991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 261099) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D74585) |
| 207L00000X Anesthesiology (Licence: NY 261099) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D74585) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2022-07-21 |