| NPI | 1114192556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10467000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 239565) |
| 207L00000X Anesthesiology (Licence: MA 229754) | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2021-07-23 |