| NPI | 1932287042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 211144) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 211144) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2015-06-16 |