| NPI | 1720069610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 180493) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09578600) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA09578600) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 180493) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09578600) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 180493) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2019-12-23 |