| NPI | 1659400679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 206663) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 206663) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2016-03-09 |