| NPI | 1194990689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA 443750) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10109800) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2022-07-27 |