| NPI | 1548825177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12502900) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101278623) |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2025-12-11 |