| NPI | 1134162431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 185824) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA50428) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2020-06-28 |