| NPI | 1154692077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 299173) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09721100) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2025-10-20 |