| NPI | 1740244771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 217486-1) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 217486-1) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 217486-1) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2024-11-18 |