| NPI | 1144201302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08349100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 246594) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2022-10-16 |