| NPI | 1578541942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA02555200) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NJ 25MA05755200) |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: NJ 25MA05755200) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2011-08-18 |