| NPI | 1124341573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09255500) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VA D0070366) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DC MD037172) | |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2023-02-11 |