| NPI | 1215270038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 57318) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10071200) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2018-07-30 |