| 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 |