| NPI | 1104027390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA08271700) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ MA08271700) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2013-05-01 |