| NPI | 1033344155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09761700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT195313) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT195313) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2025-06-23 |