| NPI | 1295736361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08184200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 201996-1) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2024-10-21 |