NPI | 1871661041 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: DE C1-0004306) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA05838200) |
Enumeration Date | 2006-12-04 |
Last Update Date | 2016-03-09 |