| NPI | 1467765149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10693000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 275367) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2023-01-16 |