| NPI | 1609805084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09590900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 218334) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2019-05-06 |