| NPI | 1952498040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 181761) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA06267400) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2019-10-01 |