| NPI | 1508852153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08532700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C10007642) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2018-04-12 |