| NPI | 1164674024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA09030600) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD433366) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 250988) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 45299) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0074044) | |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2012-06-27 |