| NPI | 1164420824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA0570800) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA57080) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2015-03-26 |