| NPI | 1811383300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY A259381-1) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY A259381-1) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY A259381-1) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY A259381-1) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY A259381-1) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |