NPI | 1619267374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA09832600) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09832600) |
Enumeration Date | 2011-04-14 |
Last Update Date | 2016-06-04 |