| NPI | 1598762171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 155488) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08591800) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2019-01-28 |