| NPI | 1902486228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA13062000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 336393-01) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2026-04-15 |