| NPI | 1538334008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10215100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 247713) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2025-04-25 |