| NPI | 1609015627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB08686800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT010997) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2025-02-28 |