| NPI | 1205112380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12022500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 263462) |
| 208D00000X General Practice (Licence: NY 263462) | |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2024-11-27 |