| NPI | 1386930600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CA A135936) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10466700) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NJ 25MA10466700) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2024-04-10 |