| NPI | 1780046151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD470624) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA12650600) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NJ 25MA12650600) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2025-10-01 |