| NPI | 1770690158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB08806800) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ MB08806800) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ 25MB08806800) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2014-06-04 |