| NPI | 1033154380 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 140588)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA03728600)  | 
| Enumeration Date | 2006-06-19 | 
| Last Update Date | 2018-06-14 |