| NPI | 1417932435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 215762) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08542400) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2017-01-04 |