| NPI | 1669654372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09614700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 249099) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2020-04-13 |