| NPI | 1801059118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 269243) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MA 251704) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MA 251704) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: NY 269243) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2025-07-17 |