| NPI | 1720472152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 298821) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 20006) |
| 207L00000X Anesthesiology (Licence: NY 298821) | |
| 208VP0000X (Licence: NY 298821) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2025-07-16 |