| NPI | 1619101656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL me146895) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 246212) |
| 207L00000X Anesthesiology (Licence: FL me146895) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 246212) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2023-09-23 |