| NPI | 1801877147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD477960) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11793000) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2023-06-30 |