| NPI | 1982919775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 256187) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08691700) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ 25MA08691700) | |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2024-04-17 |