| NPI | 1558733063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 339178) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10563800) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2025-09-26 |