| NPI | 1336584762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09636600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A118273) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2018-03-02 |