| NPI | 1457849507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11842600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 70741) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2024-04-26 |