| NPI | 1124309349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB10061600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 051857) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2023-01-23 |