| NPI | 1467740811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: NJ 25MB09826200) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MB09826200) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2024-05-24 |