| NPI | 1972664522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08550900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT186316) |
| 207L00000X Anesthesiology (Licence: NY 251884-1) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2009-05-21 |