| NPI | 1154556751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB08507400) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NJ 25MB08507400) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2021-10-29 |