| NPI | 1710069174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ ma67280) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ MA06728000) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2018-04-16 |