NPI | 1467573907 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08239400) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 241733) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2015-03-25 |