| NPI | 1093703514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9401414) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 61310) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NC 94-01414) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: SC 61310) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2024-09-19 |