| NPI | 1497846166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 203113) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25ma06843400) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2015-05-18 |