| NPI | 1104901420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06868600) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NJ 25MA06868600) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2011-01-10 |