| NPI | 1922448380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11127200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 293759) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 293759) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2022-12-09 |