| NPI | 1386842540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11898200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 277617) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2025-09-03 |