| NPI | 1639197783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA0625970) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA06259700) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-07-15 |