| NPI | 1871052647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11863700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 312253) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-12-04 |