| NPI | 1114547908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 330284) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA12274000) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-12-09 |