| NPI | 1629710827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB13209500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX W4882) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2026-09-14 |