| NPI | 1558337972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA04749000) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25ma04749000) |
| Enumeration Date | 2006-02-25 |
| Last Update Date | 2017-12-01 |