| NPI | 1750320461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD427899) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA09172000) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD427899) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA09172000) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-04-18 |