| NPI | 1215124979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08707300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT191666) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2025-07-21 |