| NPI | 1376818450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS14591) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB09832400) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2017-06-27 |