| NPI | 1497251649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12174500) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NJ 25MA12174500) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2026-03-31 |