| NPI | 1750365318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 200019-1) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: NY 200019-1) |
| 207L00000X Anesthesiology (Licence: NJ 25MA08033900) | |
| 207L00000X Anesthesiology (Licence: NY 200019-1) | |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: NJ 25MA08033900) | |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: NY 200019-1) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08033900) | |
| 208D00000X General Practice (Licence: NY 200019-1) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MA08033900) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 200019-1) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08033900) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 200019-1) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2022-01-28 |