| NPI | 1033104526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA04301200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD422397L) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-01-22 |