| NPI | 1063531218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2025-0545) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NM MD2025-0545) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: GA 80475) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2025-06-04 |