| NPI | 1770574626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25ma08212000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08212000) |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: NJ 25ma08212000) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2014-08-22 |