| NPI | 1144858572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12707200) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: MA 1018682) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-09-10 |