| NPI | 1295096147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10439700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD455921) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2019-07-09 |