| NPI | 1164985446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 329336) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A187096) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2024-07-26 |