| NPI | 1023034303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09757500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD420916) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-04-18 |