| NPI | 1801355094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 331291) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 331291) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA12449700) | |
| 207L00000X Anesthesiology (Licence: NJ 25MA12449700) | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2026-08-07 |