| NPI | 1548693310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 309122) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10323500) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2025-09-25 |