| NPI | 1245647015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 295497) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10403900) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2018-09-07 |