| 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 |