| NPI | 1124005277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 227185) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07568200) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2013-04-22 |