| NPI | 1609950062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA67508) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD056734L) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2018-11-20 |