| NPI | 1912293127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09682700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 277736) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2020-12-06 |