| NPI | 1740454115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25ma08384300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 244736) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |