| NPI | 1548256225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 183486-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08686300) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2014-10-17 |