| NPI | 1790206415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 310826) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 310826) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2023-10-04 |