| NPI | 1477510873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA0784000) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ MA07840000) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2013-05-01 |