| NPI | 1316258825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09444400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 293689) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2019-01-11 |