| NPI | 1699760868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 146477) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA04920200) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2018-07-23 |