| NPI | 1578533329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: NJ MA62053) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA062053) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2021-11-12 |