| NPI | 1245269992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09632900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA ME125725) |
| 207L00000X Anesthesiology (Licence: FL ME125725) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2025-04-29 |