| NPI | 1629299920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA08215100) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08215100) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08215100) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-08-16 |