| NPI | 1881635886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA05753500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 1555121) |
| 207L00000X Anesthesiology (Licence: CT 47804) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2025-07-21 |