| NPI | 1801902788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 259015-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD40269) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08823500) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-03-07 |