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 |