| NPI | 1457356925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ MA073025) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA073925) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2023-10-12 |