| NPI | 1861019507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB12162000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT020055) |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2024-04-26 |