| NPI | 1154564995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11734500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD448842) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2024-07-26 |