| NPI | 1639399850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 24433) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 110484) |
| 207L00000X Anesthesiology (Licence: CT 036495) | |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2007-07-08 |