| NPI | 1508093691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD460677) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25IA12857800) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2025-11-14 |