| NPI | 1598019937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101262332) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09918800) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2023-01-18 |