| NPI | 1083106702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NJ 25MA11883600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11883600) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2023-10-27 |