| NPI | 1306103643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB11982800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 283799) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2023-09-06 |