| NPI | 1790851061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MB06424500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB06424500) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-01-18 |