| NPI | 1699772160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 198371-2) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME111623) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME111623) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME111623) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2014-11-12 |