| NPI | 1407478746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12123900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 10451) |
| Enumeration Date | 2020-05-09 |
| Last Update Date | 2024-05-28 |