| NPI | 1073711958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DE C1-0012461) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 282156) |
| 207L00000X Anesthesiology (Licence: PA MD450784) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2018-12-07 |