| NPI | 1275508145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA04347800) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA04347800) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-10-29 |