| NPI | 1629074091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NJ 25MA04456000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA04456000) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2024-01-15 |