| NPI | 1578540597 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA07744800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 232253) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD447217) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2024-11-27 |