| NPI | 1184882649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MA11127800) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 262483) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2023-12-27 |