| NPI | 1316108020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD444546) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA12863700) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2025-09-25 |