| NPI | 1891770939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA08879800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200500302) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2025-01-07 |