| NPI | 1104190925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2019-00747) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-17465) |
| 207L00000X Anesthesiology (Licence: VA 0101260747) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AR E-17465) | |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2024-09-23 |