| NPI | 1134410236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NJ 25MA10029100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 261998) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2020-07-28 |