| NPI | 1093864563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA07225300) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA07225300) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2024-05-14 |