| NPI | 1952796799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA11832600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 278305) |
| 207T00000X Neurological Surgery (Licence: NJ 25MA11832600) | |
| 2086S0129X (Licence: NJ 25MA11832600) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2025-01-15 |