| NPI | 1528403086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10278900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD460925) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2018-06-20 |