| NPI | 1932109170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 65665) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 201176) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2025-12-15 |