| NPI | 1427196047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08620400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD425149) |
| 207L00000X Anesthesiology (Licence: NY 239723) | |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2014-09-03 |