| NPI | 1417924168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08226700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08226700) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08226700) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2021-06-18 |