| NPI | 1710135785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA07582100) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NJ 25MA07582100) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2011-09-21 |