| NPI | 1417107814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09263300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD431439) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2023-12-14 |