| NPI | 1841630472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10553900) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD460343) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PR 22200) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA10553900) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2022-01-06 |