NPI | 1083103071 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA11861400) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11861400) |
Enumeration Date | 2018-05-04 |
Last Update Date | 2023-06-28 |