| NPI | 1386845386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11396100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 260830-1) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2025-06-30 |