| NPI | 1760589824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: NJ 25MA06304600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA06304600) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD039559L) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA06304600) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-05-24 |