| NPI | 1588644272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 227434) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 227434) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA07665400) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME107824) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2023-08-16 |