| NPI | 1619059318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06090100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA60901) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2021-07-23 |