| NPI | 1609261700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11596300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 38281) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 91352) | |
| 207L00000X Anesthesiology (Licence: MO 2021036074) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL 149715) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MS 27887) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WV 30758) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NJ 25MA11596300) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: LA 326470) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2025-09-19 |