| NPI | 1174815591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 278132) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11635900) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2022-10-20 |