| NPI | 1477550853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0064548) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07796900) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2010-08-30 |