| NPI | 1710241252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB11019600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS018110) |
| 208600000X Surgery (Licence: PA OT014712) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2024-10-01 |