| NPI | 1548203839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD427900) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD427900) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA09478200) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MA09478200) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2023-04-18 |