| NPI | 1396768081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA06080300) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ MA060803) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ MA060803) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-04-19 |