| NPI | 1609073196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 240520-01) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08481800) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2024-09-30 |