| NPI | 1770549198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA67757) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NJ 25MA06775700) |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: NJ 25MA06775700) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2014-08-05 |