| NPI | 1932102589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA05633700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME113643) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2022-08-19 |