| NPI | 1801909247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 60625) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 05198600) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-04-09 |