| NPI | 1912952540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 272625) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 272625) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2024-11-15 |