| NPI | 1841454477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS 11245) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 250413-1) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB08733400) | |
| Enumeration Date | 2008-07-13 |
| Last Update Date | 2021-09-22 |