| NPI | 1205817095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA07548400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE CI0005742) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2013-01-15 |