| NPI | 1649531039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09826300) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 273420) |
| Enumeration Date | 2012-06-02 |
| Last Update Date | 2023-04-26 |