| NPI | 1821593799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 316366) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA12393100) |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2025-07-30 |