| NPI | 1215098868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB04850500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MB04850500) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2017-02-28 |