| NPI | 1295053171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB09516200) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB09516200) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2020-08-31 |