| NPI | 1700197522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA12468500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q7684) |
| 207L00000X Anesthesiology (Licence: VA 0101251489) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2025-09-04 |