| NPI | 1184824690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08686000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 243786-1) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-03-05 |