| NPI | 1275539645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ MA50393) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA50393) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME142797) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2021-06-08 |