| NPI | 1144679580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12052900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD470110) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2025-08-29 |