| NPI | 1952394389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08159700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 002164-1) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-07-08 |