| NPI | 1588815765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 60254784) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25ma08847600) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2011-01-27 |