| NPI | 1841394202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA06812600) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 168357) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD433043) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2015-03-27 |