| NPI | 1417118035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10020300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 246291) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2025-05-06 |