| NPI | 1316008642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06551300) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ MA06551300) |
| 207L00000X Anesthesiology (Licence: NJ MA06551300) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2017-03-01 |