| NPI | 1386637270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB058448900) |
| Additional Taxonomies | 208VP0000X (Licence: NJ 25MB05848900) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2011-10-06 |