| NPI | 1225034887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA07863200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 217213) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA07863200) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 217213) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2015-12-07 |