| NPI | 1992702997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06578800) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA65788) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2015-02-10 |