| NPI | 1083110829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB11395900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25mb11395900) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-04-21 |