| NPI | 1205997202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA06457400) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ MA06457400) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2023-06-15 |