| NPI | 1386671436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: PA MD048442L) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NJ 25MA06859100) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-04-15 |