| NPI | 1912900549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB07895900) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MB07895900) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2022-07-21 |