| NPI | 1336536176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD467243) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10589300) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2020-06-09 |