NPI | 1003249566 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME119078) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA09355100) |
Enumeration Date | 2013-08-19 |
Last Update Date | 2020-08-10 |