| NPI | 1780892901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09764800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD432977) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2018-03-17 |