| NPI | 1629287990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 246144) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25ma08168800) |
| 207R00000X Internal Medicine (Licence: NJ 25ma08168800) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 246144) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-02-24 |