| NPI | 1003473208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12277500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD483827) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2024-08-19 |