| NPI | 1821231135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08955700) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08955700) |
| 207L00000X Anesthesiology (Licence: NY 247701) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2026-06-17 |