| NPI | 1356730337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB10025600) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MB10025600) |
| 207L00000X Anesthesiology (Licence: NJ 25MB10025600) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ P14-00533) | |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2022-01-28 |