NPI | 1679655385 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA07670500) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07670500) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2025-02-10 |