| NPI | 1013243880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09308400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 269227) |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2025-09-19 |