| NPI | 1316380520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD460172) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10220000) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2018-03-17 |