| NPI | 1720160427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME95741) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07011300) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ 25MA07011300) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2025-02-18 |