| NPI | 1700924669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA07341800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07341800) |
| 207L00000X Anesthesiology (Licence: NY 216770-1) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2010-07-15 |