| NPI | 1346602562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA10736900) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MA10736900) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA10736900) | |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2024-05-01 |