| NPI | 1376572875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09723700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD467107) |
| 207L00000X Anesthesiology (Licence: CA A78879) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-10-16 |