| NPI | 1649299553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06904200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 291354) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2018-06-05 |