| NPI | 1265434005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08254500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 220847) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2015-04-17 |