| NPI | 1992703466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA06447300) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA64473) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2015-03-20 |