| NPI | 1114958626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME94746) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA074411DO) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA074411DO) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-08-20 |