| NPI | 1477508364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 163096-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08816100) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2013-06-18 |