| NPI | 1558402768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB06042200) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ MB06042200) |
| 207L00000X Anesthesiology (Licence: NJ MB06042200) | |
| 208VP0000X (Licence: NJ MB06042200) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ MB06042200) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2022-07-21 |