| NPI | 1861492076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 195492) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 195492-1) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2016-11-17 |