| NPI | 1578821757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 283977) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 283977) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2023-03-09 |