| NPI | 1871599563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08205700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD-055431L) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2023-12-01 |