| NPI | 1154853331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB10987200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 297832) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2025-06-16 |