| NPI | 1922198498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 248127) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 248127) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: NY 248127) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-12-31 |