| NPI | 1831250554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 197734) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA06544400) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2017-03-13 |