| NPI | 1073766143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08830200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 258545) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2019-10-29 |