| NPI | 1386610319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB07617400) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB07617400) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MB07617400) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-03-07 |