| NPI | 1235275504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA05324700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 53247) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2012-04-13 |