| NPI | 1588627087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 50923) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07142400) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2018-06-22 |