| NPI | 1821527060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11091000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT214037) |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2023-01-06 |