| NPI | 1033400940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS018130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB09932300) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: PA OS018130) | |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: NJ 25MB09932300) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2020-06-16 |