| NPI | 1417977810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 51644) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA05845200) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-03-17 |