| NPI | 1831686062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 317426) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 317426) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2023-11-09 |