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 | 2024-06-17 |