| NPI | 1558307934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA04462600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA04462600) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2018-01-10 |