| NPI | 1598127987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11074300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 303627) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2021-06-23 |