| NPI | 1760701460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10306000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT193052) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2025-07-30 |