| NPI | 1093027146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A125305) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A125305) |
| 208000000X Pediatrics (Licence: CA A125305) | |
| 208000000X Pediatrics (Licence: PA MT197578) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2022-01-04 |