| NPI | 1982066403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS021168) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB11215500) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB11215500) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-04-09 |