| NPI | 1639153778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C1-0008409) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08574200) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2015-07-29 |