| NPI | 1801090667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08509400) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ MA08509400) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2013-03-06 |