| NPI | 1386628436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10354000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA md050826l) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2019-02-06 |