| NPI | 1407054141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA0874300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 242816-1) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2022-01-05 |