| NPI | 1720240369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MA09267600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD445561) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-05-14 |