| NPI | 1609866946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD041920E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA06201600) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2018-04-17 |