| NPI | 1578096707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 326247) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11300700) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2024-05-09 |