| NPI | 1194036145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MA10911200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10911200) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2024-06-19 |