| NPI | 1295266724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12082800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 308479-01) |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2024-07-03 |