| NPI | 1023678430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101285413) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DC MD500003071) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2025-09-17 |