| NPI | 1659325074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08080700) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ MA08080700) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-03-06 |