| NPI | 1336167311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08694200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD053792L) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-06-09 |