| NPI | 1245524933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09850400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 267886) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2019-05-17 |