| NPI | 1508885534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08090300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME50505) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-05-07 |