NPI | 1205125812 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12334300) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA BB5204071) |
Enumeration Date | 2011-04-04 |
Last Update Date | 2025-03-10 |