NPI | 1124026893 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06216700) |
Additional Taxonomies | 174400000X Specialist (Licence: NJ MA62167) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2015-03-25 |