| NPI | 1154556835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NJ 25MA09473800) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NJ 25MA09473800) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NJ 25MA09473800) | |
| Enumeration Date | 2009-05-25 |
| Last Update Date | 2021-04-08 |