| NPI | 1174717698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08322100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 238036) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2009-02-21 |