| NPI | 1972605137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA08519500) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 256512) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2012-08-07 |