| NPI | 1043344377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NJ MA030851) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ MA030851) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ MA030851) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-08 |