| NPI | 1982607040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA07077100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07077100) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2024-04-20 |