| NPI | 1992787071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD018676E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA35712) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2016-07-26 |