| NPI | 1689736829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08381600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT186130) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2026-02-10 |