| NPI | 1003496274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA13141300) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ 25MA13141300) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2026-09-16 |