| NPI | 1235169350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME93567) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08525000) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2011-01-04 |