| NPI | 1649234394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD039367L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA06786200) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2010-07-29 |