| NPI | 1902832991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA07441200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA07441200) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2025-01-16 |