| NPI | 1093820078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 70379) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME76156) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME76156) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2024-04-22 |