| NPI | 1306804968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA07900600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 216819) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2010-08-25 |