| NPI | 1396057774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11372100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD454720) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2025-02-11 |