| NPI | 1073679767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08930900) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08930900) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD439363) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD439363) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-10-18 |