| NPI | 1053393751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 222860) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08740200) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2013-06-20 |