| NPI | 1083723175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 25659) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 25659) |
| 208000000X Pediatrics (Licence: KY 25659) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-06-13 |