| NPI | 1750322822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD020687E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA03656400) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2013-03-22 |