| NPI | 1225334295 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12788600) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 004096-1) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207L00000X Anesthesiology (Licence: IN 01089248A) | |
| 207L00000X Anesthesiology (Licence: PA MD446280) | |
| Enumeration Date | 2011-02-08 | 
| Last Update Date | 2025-09-17 |