| NPI | 1174899116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MB10291900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34.012116) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2024-05-28 |