| NPI | 1528056777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06733300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD064163L) |
| 207L00000X Anesthesiology (Licence: FL 25MA06733300) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2019-11-08 |