| NPI | 1053348128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA07601700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 227529) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 227529) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA07601700) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2021-02-11 |