| NPI | 1467453662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 160286) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA57162) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2022-09-09 |