| NPI | 1114245354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD H0070625) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB08704900) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2011-08-01 |