| NPI | 1003831363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA04368900) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA04368900) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2025-11-06 |