| NPI | 1952861064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0103394) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA12142900) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-07-28 |