| NPI | 1538151543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A15990) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q5984) |
| 207L00000X Anesthesiology (Licence: NJ 25MB07481600) | |
| 207Q00000X Family Medicine (Licence: NJ MB074816) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2018-06-15 |