| NPI | 1477797132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08856600) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 012850) |
| Enumeration Date | 2009-04-26 |
| Last Update Date | 2015-03-25 |