| NPI | 1407122609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10050500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 293803-1) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2024-05-02 |