| NPI | 1003251349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10212800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 301946) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2023-04-21 |