| NPI | 1427468461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25NJ10843500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 286042) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 286042) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2023-08-09 |