| NPI | 1750330452 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 179441)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA05831800)  | 
| Enumeration Date | 2006-05-09 | 
| Last Update Date | 2024-12-15 |