| NPI | 1740370758 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08873700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD438100) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-10-29 |