| NPI | 1508834854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 78874) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 037082) |
| 207L00000X Anesthesiology (Licence: NJ 25MA08043200) | |
| Enumeration Date | 2006-03-12 |
| Last Update Date | 2009-01-22 |