| NPI | 1871557686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 229027) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08014400) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2007-07-08 |