| NPI | 1184157257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12291100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.139747) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2024-07-10 |