| NPI | 1346266004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA5757700) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA05757700) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA05757700) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2011-10-20 |