NPI | 1619538881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB11925900) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014122) |
Enumeration Date | 2019-06-27 |
Last Update Date | 2025-07-02 |