| NPI | 1649618026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 292454) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA1004800) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2018-08-07 |