| NPI | 1629052188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: PA MD435280) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD435280) |
| 207L00000X Anesthesiology (Licence: NY 002185) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 251006) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2016-06-27 |