| NPI | 1598925380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08958900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 232550) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2011-10-13 |