NPI | 1902463136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MA11922900) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11922900) |
207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA11922900) | |
Enumeration Date | 2019-05-22 |
Last Update Date | 2024-08-20 |