| NPI | 1861545865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA65776) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 198751) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2007-07-08 |