| NPI | 1457429292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 164625-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA05452700) |
| 207L00000X Anesthesiology (Licence: NJ MA54527) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2012-04-23 |