| NPI | 1114489515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25mb1227440) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 328379) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-01-30 |