| NPI | 1629236542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 256427) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08574300) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2013-06-20 |