| NPI | 1588755292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 178491) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB04628900) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2025-09-08 |