| NPI | 1073792594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08641500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 254374-1) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2016-04-07 |