| NPI | 1487824579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 12645) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08215000) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2019-05-01 |