| NPI | 1992237499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: NY 314947) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: PA MD476677) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: PA MD476677) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 314947) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-05-25 |