NPI | 1801425376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 335734) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 335734) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 335734) | |
Enumeration Date | 2020-04-06 |
Last Update Date | 2025-08-05 |