| NPI | 1689251449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD489783) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA12753600) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-06-28 |