| NPI | 1679889315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 263710) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09528400) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA09528400) | |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2016-05-04 |