| NPI | 1679778823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08914300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 255156) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2018-05-11 |