| NPI | 1598748964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 255353) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07831900) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2015-03-19 |