| NPI | 1659377349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA03319600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD-036712-L) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2016-04-25 |