| NPI | 1275772782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 136124-1) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2007-00917) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08361100) | |
| Enumeration Date | 2009-02-08 |
| Last Update Date | 2018-07-06 |