| NPI | 1881075596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD467603) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NJ 25MA10835800) |
| 207L00000X Anesthesiology (Licence: PA MD467603) | |
| 207L00000X Anesthesiology (Licence: NJ 25MA10835800) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2026-01-09 |