| NPI | 1629211701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD447829) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09367000) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2020-05-08 |