| NPI | 1861559528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06319000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 192403) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2014-10-16 |