| NPI | 1912008806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 221849) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 09409) |
| 207LH0002X Anesthesiology Hospice and Palliative Medicine (Licence: NY 207641) | |
| 207R00000X Internal Medicine (Licence: SC 36606) | |
| 207RA0401X Internal Medicine Addiction Medicine (Licence: NY 2012522) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-04-16 |