| NPI | 1750645982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA09413100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 266582) |
| 207L00000X Anesthesiology (Licence: NJ 25MA09413100) | |
| 207L00000X Anesthesiology (Licence: FL ME125807) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 266582) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2019-11-19 |