| NPI | 1093003253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB10498900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 054827) |
| 207L00000X Anesthesiology (Licence: MA 252128) | |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2023-09-19 |