| NPI | 1043340235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 160727-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA04866100) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2015-03-26 |