| NPI | 1710294210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08826400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD466140) |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2019-01-07 |