| NPI | 1487071395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10599300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 66163) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 66163) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2024-10-11 |