| NPI | 1700024064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 256586) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY A256586-01) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 256586) | |
| Enumeration Date | 2009-01-25 |
| Last Update Date | 2024-02-13 |