| NPI | 1336320852 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08278800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD432604) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2012-06-15 |