| NPI | 1679928386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11933600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 68060) |
| Enumeration Date | 2016-05-01 |
| Last Update Date | 2023-07-28 |