| NPI | 1861998379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA11432400) |
| Additional Taxonomies | 208VP0000X (Licence: NJ 25MA11432400) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA11432400) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2026-04-06 |